What Findings on Chest CTs Can Delay Diagnosis of Pleuropulmonary Paragonimiasis?

Purpose: The purpose of this study was to investigate which findings were delayed in diagnosis with respect to chest CT findings of paragonimiasis. Methods: This retrospective, informed questionnaire study was conducted to evaluate chest CT scans of 103 patients (58 men and 45 women; mean age 46.1 +/- 14.6 years). The patients were diagnosed with paragonimiasis from 2003 to 2008 in four tertiary hospitals. Statistical analysis was performed using the chi-square test to identify differences between an initially correct diagnosis and an incorrect one of paragonimiasis on chest CT scans, for which we evaluated such variables as the location of lesion, type of parenchymal lesions, and worm migration track. Results: Nodular opacities on chest CT scans were the most common findings (53/94, 56.4%). The sign of worm migration tracks was only present in 18.1% of cases (17/94). Although statistically insignificant, the form of consolidation (18/25, 72%) and mass (6/8, 75%) on CT was common in correct diagnostics, and the form of the worm migration track (12/17, 70.6%) was high in correct diagnostics. Conclusion: A delayed diagnosis of paragonimiasis may often be made in patients with non-nodular, parenchymal lesions who are negative for worm migration track on chest CT scans.